[Pediatrics - Perthes disease : current knowledges and treatment]

Area of Science:

• Orthopedics
• Pediatric Orthopedics
• Pediatric Bone Diseases

Background:

• Perthes's disease is characterized by interrupted vascularization of the femoral head's epiphyseal nucleus, leading to avascular necrosis.
• This necrosis weakens the bone, resulting in subchondral fractures and femoral head deformation.
• Extrusion of the femoral head is a critical complication necessitating surgical intervention.

Purpose of the Study:

• To summarize the pathophysiology of Perthes's disease.
• To highlight the importance of early detection of femoral head extrusion.
• To discuss the implications of joint congruence loss and treatment strategies.

Main Methods:

• Review of Perthes's disease pathophysiology.
• Analysis of clinical presentation and complications.
• Discussion of management principles, including non-weight bearing.

Main Results:

• Avascular necrosis leads to femoral head deformity and loss of joint congruence.
• Femoral head extrusion significantly increases the risk of early hip osteoarthritis.
• Non-weight bearing is a key conservative measure to prevent further subchondral fractures.

Conclusions:

• Early recognition of Perthes's disease and potential complications like extrusion is vital.
• Maintaining joint congruence is essential for preventing long-term functional limitations and osteoarthritis.
• Non-weight bearing management requires substantial patient and family commitment but mitigates fracture risk.